Psychiatric Nurses’ Practice with Parents who have Mental Illness, their Children and Families, within Adult Mental Health Services in Ireland

Introduction: While it is recommended that mental health professionals engage in family focused practice (FFP), there is limited understanding regarding psychiatric nurses’ practice with parents who have mental illness, their children and families in adult mental health services.

Methods: This study utilized a mixed methods approach to measure the extent of psychiatric nurses’ family focused practice and factors that predicted it. It also sought to explore the nature and scope of high scoring psychiatric nurses’ FFP and factors that affected their capacity to engage in FFP. Three hundred and forty three psychiatric nurses in 12 mental health services throughout Ireland completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Fourteen nurses who achieved high scores on the FFMHPQ also participated in semi-structured interviews.

Results: Whilst the majority of nurses were not family focused a substantial minority were. High scoring nurses’ practice was complex and multifaceted, comprising various family focused activities, principles and processes. Nurses’ capacity to engage in FFP was determined by their knowledge and skills, working in community settings and own parenting experience.

Global Trade Governance and ASEAN: Studies of Trade-Related Aspects of Labor, Environment and Culture in Southeast Asia

Thesis (Ph.D.)--University of Washington, 2016-08

Evolution of an Interactive Online Magazine for Students, Academics and Expert Practitioners to Engage Students in ESD

Urgency to embed awareness of sustainability principles and practice across society, and need for digital literacy and advocacy for sustainability are reshaping ESD. These, together with developments in learning and teaching, demand new tools to support implementation of project-based learning and more interactive approaches. This investigation explores the evolution of susthingsout.com, an online magazine for students, academics and expert practitioners, developed by the University of Worcester. This comprises two parts; the first, a private site specifically for students involved in sustainability learning on-campus; the second, an open-access site developed to deliver sustainability information and good practice across campus, community and not-for-profit and commercial organisations. This paper involves only the private site i.e. the equivalent of an in-house VLE specifically designed to support the teaching of sustainability to multi-disciplinary first and second year undergraduate students. It reports on the progress of the VLE, following three years of use and initial improvements, in terms of the student support and engagement, as well as considering the practical issues affecting these. The results fall into four categories of pedagogical, operational, cultural and external factors, which are synthesised to capture and share emerging knowledge of good practice offering insights to other developers of online sustainability materials.

Princípios da reabilitação de edifícios: aplicação a casos de estudo

Trabalho final de Mestrado conducente ao grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

Evaluation of Urban Spaces from the Perspective of Universal Design Principles: The Case of Konya/Turkey

During the process of accessing services provided within urban interior and outer spaces the elderly and disabled individuals encounter with a myriad of problems due to the limitations posed by structured environments. This limitation hinders elderly and disabled individuals from mobility without assistance, which in turn negatively affects their full participation to urban and social life. Rearrangement of urban spaces to meet the needs of elderly and disabled individuals would correspondingly bolster life quality of the entire range of users. Within the scope of present research, as mandated by universal design principles to stick to plans and designs approaches inclusive for all users, it is aimed to conduct evaluations on the use of urban outer spaces situated within Konya City Center. In the hypothetical and theoretical part of this paper, the perception of disability throughout historical process has been examined from a sociological perspective. In addition, concept of universal design, its principles and gravity have also been elaborated. In the part dealing with the case study, outer spaces within Konya City Center have been analyzed with respect to universal design principles and a range of suggestions have been developed.

Pearly gate of the true life and doctrine for believers in Christ. ...

"The following is my understanding of scripture teaching in harmony with shaker principles and practice. A.G. Hollister."--Pref.

Tobacco and alcohol use in adolescents with unplanned pregnancies: relation with family structure, tobacco and alcohol use at home and by friends.

Background: Recent publications show that smoking and alcohol use among adolescents with unplanned pregnancy is increasing and the causes need to be further studied. Objective: To determine the association between living in a non-intact family household and the presence of smokers and consumers of alcoholic beverages in the adolescents’ environment with smoking and consuming alcoholic beverages in adolescents with unplanned pregnancies. Methods: A cross-sectional study was carried out among 785 pregnant adolescents, aged 13-19 years. Data was collected by trained interviewers using a self-administered questionnaire. The association was determined using multivariate logistic regression analysis. Results: In adolescents with unplanned pregnancies, the prevalence of active smoking was 21.2% and of alcohol consumption, 41.5%. The percentage of smoking at home was 57.4% and alcohol consumption, 77.5%. Approximately, 80.3% of adolescents with unplanned pregnancies had friends who smoked and 90.6% consumed alcoholic beverages. Multivariate logistic regression analysis shows that having friends who smoke or who consume alcoholic beverages is the most important risk factor for substance use in adolescents with unplanned pregnancies. Smoking and alcohol consumption at home are not associated with smoking in adolescents with unplanned pregnancies. Conclusion: Socializing with friends who smoke and/or consume alcoholic beverages constitutes the most important risk factor for substance use among adolescents with unplanned pregnancies.

An investigation into the folding and assembly of engineered antibodies and novel antibody formats

Monoclonal antibodies and novel antibody formats are currently one of the principal therapeutic in the biopharmaceutical industry worldwide and are widely used in the treatment of autoimmune diseases and cancer. It is for this reason that the productivity and quality of antibody production requires improvement; specifically investigations into the engineering of antibodies and any issues that may arise from the production of these therapeutics. The work presented in this thesis describes an investigation into the folding and assembly of seven antibodies plus the novel antibody format FabFv. IgG is comprised of two identical HCs and two identical LCs. The folding process of immunoglobulin is controlled by the CH1 domain within the HC. The CH1 domain remains in a disordered state and is sequestered by BiP in the endoplasmic reticulum. Upon the addition of a folded CL domain, BiP is displaced, the CH1 domain is able to fold and the complete IgG protein can then be secreted from the cell. The results presented in this thesis however, have outlined an additional mechanism for the folding of the CH1 domain. We have shown that the CH1 domain is able to fold in the absence of LC resulting in the secretion of HC dimers in a VH dependent manner. The proposed mechanism for the secretion of HC dimers suggests that some VH domains can interact with each other in order to bring the CH1 domains in close proximity to enable folding to occur. As HC dimer secretion is a hindrance in antibody production, this result has highlighted an engineering target to improve antibody yield. Examination of the folding of IgG4 with the variable region A33 has revealed the inability to secrete LC dimers, cleavage of the HC during expression and secretion of HC dimers in the Fab, FabFv and full length forms. The attributes described have also been shown to be variable region dependent. This has introduced a new concept that the variable domain is important in determining the expression and secretion of antibodies and their individual chains. Pulse chase and 2D gel electrophoresis analysis of the novel antibody format FabFv has revealed that the folding and expression of the LC and HC causes multimeric species of FabFv to be secreted, as opposed to the monomeric form which is the desired therapeutic. Our hypothesis is that this process occurs via a LC dependent mechanism. The proposed hypothesis suggests that further engineering to the LC could diminish the formation and secretion of FabFv multimers. The results from these investigations can be applied to increase the productivity of therapeutics and increase the biological understanding of the domain interactions of IgG during folding, assembly and secretion.

Distance and overcurrent relay coordination considering non standardized inverse time curves

Protective relaying comprehends several procedures and techniques focused on maintaining the power system working safely during and after undesired and abnormal network conditions, mostly caused by faulty events. Overcurrent relay is one of the oldest protective relays, its operation principle is straightforward: when the measured current is greater than a specified magnitude the protection trips; less variables are required from the system in comparison with other protections, causing the overcurrent relay to be the simplest and also the most difficult protection to coordinate; its simplicity is reflected in low implementation, operation, and maintenance cost. The counterpart consists in the increased tripping times offered by this kind of relays mostly before faults located far from their location; this problem can be particularly accentuated when standardized inverse-time curves are used or when only maximum faults are considered to carry out relay coordination. These limitations have caused overcurrent relay to be slowly relegated and replaced by more sophisticated protection principles, it is still widely applied in subtransmission, distribution, and industrial systems. In this work, the use of non standardized inverse-time curves, the model and implementation of optimization algorithms capable to carry out the coordination process, the use of different levels of short circuit currents, and the inclusion of distance relays to replace insensitive overcurrent ones are proposed methodologies focused on the overcurrent relay performance improvement. These techniques may transform the typical overcurrent relay into a more sophisticated one without changing its fundamental principles and advantages. Consequently a more secure and still economical alternative can be obtained, increasing its implementation area

Patología andina relacionada al uso de plantas medicinales en los mercados 10 de Agosto, el Arenal y 9 de Octubre, de la Ciudad de Cuenca, 2015

Antecedentes: en Cuenca el uso de plantas medicinales en patologías tradicionales según la cosmovisión andina se mantiene vigente, en los mercados es habitual ver personas que buscan esta medicina, haciendo importante un estudio de la problemática. Objetivo: estudiar las patologías andinas relacionadas al uso de plantas medicinales en los mercados 10 de Agosto, el Arenal y 9 de Octubre de la ciudad de Cuenca. Método: investigación cualitativa, enfoque narrativo e interpretativo, con participación de seis mujeres de sabiduría de los mercados de Cuenca. Las técnicas empleadas: observación directa y entrevistas semi-estructuradas, diario de campo, grabaciones y fotografías. Los datos se procesaron en categorías y diagramas en Atlas.ti, se presentan en narraciones y esquemas. Resultados: las patologías andinas tratadas comúnmente; en el recién nacido, el mal de ojo; lactantes, el espanto; escolares, el shungo; adolescentes y adultos los nervios. Etiologías: estación del año, ambientes desagradables, castigo divino y causas humanas. Sintomatología compromete el estado general: irritabilidad, llanto y decaimiento. Tratamiento: fe cristiana, ritual de limpia y herramientas complementarias. Para la limpia se usa un atado de plantas medicinales, las más utilizadas: chilchil, ruda, eucalipto y flor de guano. Conclusiones: La patología andina tiene leyes y principios propios, las enfermedades mayormente atendidas: el mal de ojo, espanto, mal aire y shungo. Sintomatología es de tipo general. El tratamiento se basa en el ritual con el atado de plantas medicinales y el huevo de gallina. Cada enfermedad se explica en base a una medicina de tipo mágico-religiosa.

EVALUATION OF NON-STATIONARITY IN ANNUAL MAXIMUM FLOOD SERIES OF MODERATELY IMPAIRED WATERSHEDS IN THE UPPER MIDWEST AND NORTHEASTERN UNITED STATES

United States federal agencies assess flood risk using Bulletin 17B procedures which assume annual maximum flood series are stationary. This represents a significant limitation of current flood frequency models as the flood distribution is thereby assumed to be unaffected by trends or periodicity of atmospheric/climatic variables and/or anthropogenic activities. The validity of this assumption is at the core of this thesis, which aims to improve understanding of the forms and potential causes of non-stationarity in flood series for moderately impaired watersheds in the Upper Midwest and Northeastern US. Prior studies investigated non-stationarity in flood series for unimpaired watersheds; however, as the majority of streams are located in areas of increasing human activity, relative and coupled impacts of natural and anthropogenic factors need to be considered such that non-stationary flood frequency models can be developed for flood risk forecasting over relevant planning horizons for large scale water resources planning and management.

Quantification of standards of proof thresholds in criminal and civil litigation

Standards of proof in law serve the purpose of instructing juries as to the expected levels of confidence in determinations of fact. In criminal trials, to reach a guilty verdict a jury must be satisfied beyond a reasonable doubt, and in civil trials by a preponderance of the evidence. The purposes of this study are to determine the quantitative thresholds used to make these determinations; to ascertain the levels of juror agreement with basic principles of justice; and to try to predict thresholds and beliefs by juror personality characteristics. Participants read brief case descriptions and indicated thresholds in percentages, their beliefs in various principles, and completed three personality measures. A 92-94% threshold in criminal and an 80% threshold in civil matters was found; but prediction by personality was not supported. Significant percentages of jurors disavowed the presumptions of innocence and right to counsel.

Cordectomía por sustracción pedicular en la columna dorsal y lumbar en fracturas traumáticas: experiencia en el hospital universitario mayor Mederi y revisión sistemática de la literatura

Objetivo: Presentar la experiencia con la técnica de corpectomia por sustracción pedicular en fracturas traumática a nivel de la columna dorsal y Lumbar en el Hospital Universitario Mayor en Bogotá y hacer una revisión sistemática de la literatura de esta técnica quirúrgica. Material y métodos: Se realizó un análisis retrospectivo de las historias clínicas de pacientes que consultaron al servicio de neurocirugía entre los años 2013 y 2015 con fracturas traumáticas a nivel de la columna dorsal y lumbosacra. Se realizó un análisis de déficit neurológico pre y posoperatorio por medio de la Clasificación neurológica estándar de lesión medular (ASIA), al igual que tiempos de cirugía, sangrado intraoperatorio y complicaciones. A su vez se realiza una revisión sistemática de la literatura sobre esta técnica quirúrgica. Resultados: El total de pacientes que se sometieron a cirugía fue de 32, de los cuales el tiempo quirúrgico promedio fue de 396 min, se obtuvo un ASIA prequirúrgico B: 50% C: 47% y E: 3%. El ASIA post operatorio fue de B: 9% C: 47% D: 38% E: 6%. Se obtuvo una mejoría del déficit neurológico en el 75% los pacientes intervenidos. El promedio de sangrado fue de 1,223 cc. Se tuvieron 4 complicaciones, 2 hematomas en lecho quirúrgico que requirió re intervención y dos fistulas de líquido cefalorraquídeo las cuales se manejaron con vendaje compresivo y reposo absoluto. Conclusiones: La corpectomia por sustracción pedicular requiere de un adecuado entrenamiento y un grupo multidisciplinario dentro de los que se incluye neuroanestesiologo, a su vez de neurocirujanos entrenados en columna. Este abordaje presenta grandes beneficios como disminución de tiempos quirúrgicos, disminución de sangrado intraoperatorio y disminución de morbilidad entre otras.

Retos en la implementación de las normas internacionales al interior de los estados. estudio de caso: la región del Mekong y el protocolo de Palermo contra la trata de personas. (2007-2014)

El presente estudio de caso tiene como principal objetivo el de analizar la manera como las características sociopolíticas de los Estados del Mekong, específicamente en el caso de Camboya y Myanmar, dificultan la implementación de las normas enunciadas en el Protocolo de las Naciones Unidas para Prevenir, Reprimir y Sancionar la Trata de Personas, Especialmente Mujeres y Niños, también conocido como el Protocolo de Palermo. En este sentido, se parte de las características principales del Protocolo y de la manera como el tráfico de personas se presenta en el Mekong para posteriormente analizar la forma como la corrupción, la impunidad y la desigualdad de género representan retos sociopolíticos que obstruyen la implementación de los mandatos internacionales enmarcados en este instrumento

Papel de la comunidad internacional en la resocialización de niños soldados desvinculados del ejército de resistencia del señor en Uganda (2002-2013)

El objetivo de esta investigación diagnóstica es evaluar las acciones de la Comunidad Internacional en materia de resocialización de niños soldados desvinculados del Ejército de Resistencia del Señor (ERS) en Uganda durante el periodo de 2002 a 2013. Para ello, se hace un análisis de las causas de la existencia de niños soldados, donde se tiene en cuenta la evolución del concepto de la infancia y las particularidades que éste representa en el contexto africano. Así mismo, son analizados los alcances y limitaciones del modelo de asistencia humanitaria para la protección de la niñez enfatizando en los procesos de resocialización brindados a los niños desvinculados del ERS. Esto con el fin de evidenciar las limitaciones de la actuación de la Comunidad Internacional, y brindar una serie de recomendaciones para la implementación de programas de resocialización enfocados en la infancia.